More of ICU practice

This week I have worked in evening shift and also morning shift.  The first thing we do staring a shift is the report, we have two reports one from the doctor at the meeting room and then a second report from the nurse directly at beds patient.  We just listen the nurse report for the patients we get, like this if the patient is awake, she/he can also know what the status is. After this we do a box control, we control:

  • Ambu is ready
  • Alarms limits on monitoring are correct
  • Suctioning machine is working and there are enough suctioning cannulas
  • There are electrodes, masks and sterile gloves at box
  • Rescue medicines on reach
  • Arterial line bag is at 300 mmHg
  • Drainages are working
  • Null of Arterial line
  • Perfusion pumps are in correct order
  • For intubated patients, inflated cuff is at 30

After this we start making rounds, these rounds will be repeated every hour; this means…confirm vitals, check medicines or doctors orders. These is all in the computer and we document at same time. In between the rounds we do Hygiene and change bed, if possible, mobilize patient to chair and activate them a little, later we the physio will come and mobilize them too. Doctors also come regularly and give you new orders, you need to constant document this and also report the care plan once a shift. If patient has a dialysis machine attached, you need to care about that bags are filled with necessary products and take the waste bag too. Every 2 hours we take blood samples form arterial line and from venous line. We can do corrections on treatment based on results, of course when you are novice you can ask for doctors confirmation. Then at end of shift we do our report to the nurse who will take over and enjoy our rest of day.

This week I had also the opportunity to participate in 2 reanimations, I did not do the compressions myself, but I helped with preparing medicines and attending doctors directions. It actually went well and the reaction from my side was good, I was not overwhelmed about the situation, I just attended the orders as they came, and everything went well. I was surprised how the team works and participated in a very organized way inside of the messy situation. I must say that a good leader makes the situation easier and the doctor in charged was very good on that.

See you next week!